REIGNITING THE FLAME IN SURGERY: EXPLORING HEALTH SYSTEM DRIVERS AND INTERVENTIONS FOR PHYSICIAN BURNOUT

Abstract

Burnout is a psychological syndrome characterized by feelings of exhaustion, cynicism, and inefficacy, and is particularly prevalent in surgical specialties. Despite the widespread recognition that burnout is the result of exposure to chronic job stressors, research on burnout among physicians has primarily focused on individual correlates and solutions to this issue. We also have a limited understanding of what kinds of interventions have become available to physicians following the pandemic and what the most effective options are for those in independent practice. Thus, this thesis serves to fill a gap in the literature on physician burnout by using a validated organizational framework to identify the organizational drivers of burnout among surgeons and McMaster and update the literature on the state of burnout interventions in medicine. The first chapter explores the state of the literature on physician burnout, with a specific focus on surgical specialties and the theoretical gaps that exist in this field. Chapters two through four describe the design and findings of a mixed methods study exploring surgeons’ experiences with burnout and the workplace stressors associated with its symptoms. Chapter five consists of a systematic review and meta-analysis evaluating the effectiveness of interventions for physician burnout and provides a methodological critique of the available studies in this field. Finally, chapter six integrates the finding from the quantitative and qualitative strand of the mixed methods study while considering the findings in reference to available interventions. The findings presented in this thesis provide tangible recommendations to McMaster’s Department of Surgery on how to improve burnout symptoms with specific reference to the role of payment structures, tensions among leadership positions, patient care burden, moral injury, workplace incivility, and gender inequity. It also highlights opportunities for future intervention development focusing on health system stressors and organizational structures.